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Deaths under state’s new Death With Dignity Act up slightly in second year

Eighty-seven people requested and received lethal doses of medication in 2010, up from 65 for a 10-month period in 2009, under Washington’s Death With Dignity Act passed by a vote of the people in 2009.

The 87 prescriptions were written by 68 different physicians and dispensed by 40 different pharmacists, Washington’s second annual report on the Death with Dignity Act shows.

“It’s hard to tell if participation in the act increased in 2010,” the state Department of Health said in an announcement releasing the report. Although fewer lethal doses of medication were dispensed in 2009, the law was in effect for less than 10 months in 2009 compared to 12 months in 2010.

Of the 87 people who received lethal doses of prescription medication in 2010, 72 are known to have died. Fifty-one died after ingesting the medication.

Those who died were between the ages of 52 and 99. More than 90 percent lived west of the Cascades. Most had terminal cancer. All of the patients who received medication and died expressed concern about loss of autonomy as a reason for requesting a prescription, according to prescribing physicians.

Robb Miller, executive director of Compassion & Choices for Washington or C&C, a patient-centered, end-of-life advocacy organization, said there are no surprises in the department’s report.

Opponents of Initiative 1000 predicted only a few doctors would prescribe the life-ending medications, Miller said. “That hasn’t happened. I’m really pleased to see that.”

Miller said it’s also positive that 84 percent of those took the medications and died were enrolled in Hospice programs. That’s up from last year’s numbers, he said.

Miller would like to see all of those requesting life-ending medications take advantage of Hospice programs, because end-of-life issues, such as pain, are addressed.

People shouldn’t be using the law for the wrong reasons, he said.

Miller pointed out many of the patients who received the medication didn’t use it. “The law is providing peace of mind and control,” he said.

However, a statement from C&C about the department report, said some terminal patients wait until it’s too late.

“It is never too early to begin a discussion with your doctor about the options you would want to consider if you were diagnosed with a terminal illness,” Tom Preston, M.D., one of C&C’s medical directors, said.

“We encourage terminal patients to speak with their doctor and C&C as soon as they have questions or concerns,” Preston said. “Most people don’t understand that there are two waiting periods, including a 15-day waiting period between oral requests, and that patients are required to be evaluated by two physicians. This takes time. Don’t wait until it’s too late.”

When asked how the Death With Dignity Act is working, the department couldn’t comment, said spokesman Donn Moyer.

“Under Washington’s Death with Dignity Act, the department collects information from patients and providers who choose to participate, monitors compliance with reporting requirements, and produces an annual statistical report,” said Moyer.

The department isn’t involved in how the law is being carried out or how well it’s going, other than the reporting element, he said.

“This agency’s role is limited to overseeing the production and submission of the forms, compiling an annual report, and, if there were to be any complaints against the health care providers in the system, those complaints would be reviewed by the agency and its partner boards and commissions and pursued if necessary,” Moyer said.

No complaints about health care providers related to the act have been filed, he added.

Moyer pointed out the report offered this information on how the law is working:

Of the 51 participants in 2010 who took the medication and died:

· 90 percent were at home and 84 percent were enrolled in hospice care.

· No complications of taking the medication were reported.

· Emergency medical services weren’t called for intervention after any participant took the medication.

Before the Death With Dignity Act was passed, physician-assisted deaths did occur. Medications were prescribed for other purposes and taken by patients with or without the physician’s knowledge.

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